Oklahoma § 56-1004 - Potential recipient's authorization to examine records Provider's signed statement as to accuracy of reports, etc. Maintenance of records - Access to records - Confidentiality of

§ 56-1004. Potential recipient's authorization to examine records Provider's signed statement as to accuracy of reports, etc. Maintenance of records - Access to records - Confidentiality of

records and information - Disclosure - Liability.

Oklahoma Statutes - Title 56. Poor Persons

A. No potential Medicaid recipient shall be eligible for

medical assistance unless such recipient has, in writing, authorized

the Oklahoma Health Care Authority and the Attorney General to

examine all records maintained as required by the Oklahoma Medicaid

Program by the recipient, or of those receiving or having received

Medicaid benefits through the recipient, whether the receipt of such

benefits would be allowed by the Oklahoma Medicaid Program or not.

B. 1. Each application to participate as a provider in the

Oklahoma Medicaid Program, each report stating income or expense

upon which rates of payment are or may be based, and each invoice

for payment for a good or a service provided to recipient, shall

contain a statement that all matters stated therein are true and

accurate, signed by the provider or his or her agent. Any person

who signs this statement or causes another to sign this statement

knowing the statement to be false shall be guilty of perjury. For

purposes of this subsection, an individual who signs on behalf of a

provider shall be presumed to have the authorization of the provider

and to be acting at his or her direction.

2. All providers subject to the Oklahoma Medicaid Program are

required to maintain at their or its principal place of Medicaid

business all such records at least for a period of six (6) years

from the date of claimed provision of any goods or services to any

Medicaid recipient.

C. The Attorney General shall be allowed access to all records

of persons and Medicaid recipients under the Oklahoma Medicaid

Program which are held by a provider or the Oklahoma Health Care

Authority for the purpose of investigating whether any person may

have committed the crime of Medicaid fraud, or for use or potential

use in any legal, administrative, or judicial proceeding. In

carrying out the purposes of the Oklahoma Medicaid Program Integrity

Act, the Attorney General may take possession of records held by a

provider by subpoena, in which case copies of those records obtained

by the Attorney General which are necessary for the provider to

continue doing business shall be supplied to the provider, or the

Attorney General may elect to require that the provider supply the

Medicaid fraud control unit within the office of the Attorney

General with copies of the records. Upon request, the Attorney

General shall be granted access to records, including electronic

data, held by the Oklahoma Health Care Authority for the purpose of

investigating whether any person or entity may have committed the

crime of Medicaid fraud.

D. Records obtained or created by the Authority or the Attorney

General pursuant to the Oklahoma Medicaid Program Integrity Act

shall be classified as confidential information and shall not be

subject to the Oklahoma Open Records Act or to outside review or

release by any individual except, if authorized by the Attorney

Oklahoma Statutes - Title 56. Poor Persons

General, in relation to legal, administrative, or judicial

proceeding.

E. No person holding such records may refuse to provide the

Authority or the Attorney General with access to such records on the

basis that release would violate any recipient's right of privacy,

any recipient's privilege against disclosure or use, or any

professional or other privilege or right. The disclosure of patient

information as required by the Oklahoma Medicaid Program Integrity

Act shall not subject any physician or other health services

provider to liability for breach of any confidential relationship

between a patient and a provider.

Added by Laws 1989, c. 220, § 4, operative July 1, 1989. Amended by

Laws 1990, c. 144, § 3, emerg. eff. May 1, 1990; Laws 1995, c. 306,

§ 3, eff. July 1, 1995; Laws 2012, c. 244, § 2, eff. Nov. 1, 2012.